Monday, 29 July 2013

MS Treatment May Help Neuropathy By Protecting Myelin

Today's post from (see link below) the site of the Neuropathy Association, may well turn out to be a very important one regarding breakthroughs in neuropathy treatment. It's a long way off yet, from becoming a standard treatment but the injection of multiple sclerosis patients with their own white blood cells, seems to re-set the patient's immune system. In this way, attacks on myelin (the protective sheath around nerves) would be prevented because myelin would be 'seen' to be harmless. Many neuropathy patients have myelin damage or degradation, which leads to the symptoms we all know and hate, so finding a way of protecting myelin from external attack. The article is somewhat technical in nature but is worth sticking with as the information may well prove to be one of the most promising advances in neuropathy treatment in the future.

Could This MS Breakthrough Have Implications For Neuropathy?
By Natacha T. Pires, MBBS, Director, Medical and Public Affairs June 26, 2013

Earlier this month, an experimental treatment that involves injecting patients with multiple sclerosis (MS) with their own white blood cells made headlines across the U.S. and around the world. The treatment study’s results -- published in the medical journal “Science Translational Medicine” -- showed it was safe and it dramatically reduced patients’ immune systems’ reactivity to myelin by 50 to 75%.

Read Northwestern University’s press release about this breakthrough…

"Theoretically our approach to re-set the immune systems of patients with multiple
sclerosis would be applicable to any autoimmune disease, including autoimmune
neuropathies." - Dr. Stephen Miller

While this breakthrough study gives hope to people living with MS, it also got the attention of people with other autoimmune diseases, including autoimmune neuropathies.

Multiple Sclerosis -- An Autoimmune Disease Multiple sclerosis is a chronic often disabling, autoimmune disease characterized by the immune system attacking and destroying the myelin that insulates the nerves in the spinal cord, brain, and optic nerve. As the myelin is gradually destroyed, MS patients experience a range of symptoms including numbness in the limbs, paralysis, or loss of vision.

Current MS therapies suppress the entire immune system, leaving patients vulnerable to infections and cancer.

New MS Treatment Works By ‘Tricking’ The Body’s Immune System In the phase 1 clinical research study -- comprising nine MS patients who were treated in Hamburg, Germany -- the researchers filtered the white blood cells out of the patients' blood, processed them, and combined them with myelin antigens (the portion of the myelin protein that the immune system reacts to). These white blood cells were then injected back into the patients -- the intent being to stealthily ‘trick’ the immune system into thinking myelin is “harmless” and developing a tolerance to them.

“The main goal of the study was to show the treatment was safe and tolerable. It showed that injecting up to 3 billion white blood cells carrying myelin antigens resulted in no adverse effects in the MS patients,” added study researcher Dr. Stephen Miller -- the Northwestern University Feinberg School of Medicine microbiologist -- who has been refining this approach at building immune tolerance for more than three decades using animal models of MS to get us to this point. The study was a collaboration among researchers at Northwestern University, the University Hospital Zurich in Switzerland, and the University Medical Center Hamburg-Eppendorf in Germany. It was supported by the German Federal Ministry for Education and Research and the Cumming Foundation.

The research study -- designed to test the treatment’s safety -- showed the treatment was safe and well tolerated and also reduced immune system reactivity to myelin by 50 to 75%. The study also showed that the MS treatment did not reactivate the patients' MS and it did not affect the ability of their immune system to react to real pathogens. As part of the research study, the researchers tested the patients' immunity to tetanus because they had all received tetanus shots in their lifetime. One month after receiving the MS treatment, their immunity to tetanus remained strong, suggesting the treatment had only affected their immune system's reaction to myelin.

Does This MS Breakthrough Have Implications for Neuropathy?

 Given the broad implications for this breakthrough therapy, we recently asked Dr. Miller to shed light on the glimmer of hope we see in this therapy for people with neuropathy—specifically autoimmune neuropathies. Dr. Miller responded, "Theoretically our approach to re-set the immune systems of patients with multiple sclerosis would be applicable to any autoimmune disease, including autoimmune neuropathies. Effective therapy for any autoimmune disease would, however, require precise knowledge of the autoantigen(s) targeted in the particular disease -- these antigens would then be coupled to the carrier cells or nanoparticles and tolerance induced by intravenous infusion similar to what was done in the phase 1 trial in MS patients."

Building Immune Tolerance Could Work For Other Diseases With phase 1 clinical research study confirming the safety of the treatment in humans, the researchers are now planning to conduct a larger -- phase II -- study with more patients and a longer follow-up. "In the phase 2 study, we want to treat patients as early as possible in the disease before they have paralysis due to myelin damage. Once the myelin is destroyed, it's hard to repair that," noted Dr. Miller.

With further testing the researchers believe this therapeutic approach could be modified to treat other autoimmune diseases and allergies as well--by “switching out" substances that trigger specific diseases. "For example, in type 1 diabetes, we could attach insulin, or in allergy [patients], we could use peanut antigens," added Dr. Miller. The researchers have already published some preclinical studies showing the treatment could be effective in treating type 1 diabetes, airway allergy (asthma), and peanut allergies in mice.

The MS human study relates directly to Dr. Miller’s recently published research in mice in which he used nanoparticles -- instead of a patient’s white blood cells -- to deliver the myelin antigen. Using a patient’s white blood cells is a costly, complex, and labor-intensive procedure. Dr. Miller’s study, published in the journal “Nature Biotechnology,” showed the nanoparticles -- which are significantly cheaper -- could be as effective as the white blood cells serving as delivery vehicles and inducing tolerance to myelin in mouse models of MS. Cour Pharmaceutical Development Company now has the license for the nanoparticle technology which is undergoing preclinical development.

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